Combination magnifying device, particularly a microscope comprising a measuring device

ABSTRACT

The invention concerns a combination of a microscope with a measurement device, in particular a diagnostic device, that is usable during an operation on or examination of a specimen performed with the microscope. During the operation or examination, specimen data that are ascertained or determined by the measurement device are directly displayable in the microscope as an optical signal. In the event the measured data of the specimen exceed or fall below threshold values and/or interval values, a warning signal is triggerable by way of which further actions, such as shutdown or switchover actions, can be automatically executed as applicable.

CROSS REFERENCE TO RELATED APPLICATIONS

[0001] This invention claims priority of the Swiss patent applicationno. 2383/99 which is incorporated by reference herein.

[0002] 1. Field of the Invention

[0003] The invention concerns a combination of a magnification device,in particular a microscope, with a measurement device, in particular adiagnostic device, usable during an operation on or examination of aspecimen, which in particular is a human or animal body part or organ(part), performed with the magnification device or the microscope. Theinvention concerns in particular a device for use during the performanceof operations on the human or animal eye with a magnification device, inparticular with a surgical microscope which comprises an objectivesystem and optical devices for viewing the eye through an eyepiecesystem. The invention also concerns a surgical microscope for performingoperations on the human or animal eye.

[0004] 2. Background of the Invention

[0005] Examination microscopes, surgical microscopes, and othermagnification devices and diagnostic units for examination and forperforming operations on various organs and organ parts are known in anumber of embodiments. Some of these known units are those that are usedin the performance of ophthalmic operations or for the examination ofeyes.

[0006] Reference will be made hereinafter especially to microscopes orsurgical microscopes, the invention not being limited thereto. Inparticular, these also include other magnification devices, such asloupes or the like, for observing or magnifying an object or surgicalfield or the like.

[0007] For example, a number of surgical microscopes for performingophthalmic operations are known from the existing art. U.S. Pat. No.5,135,299, for example, discloses a surgical microscope in which thereis provided a special optical illumination system which is arranged andconfigured in such a way that the axis of the beam path of theillumination system does not coincide with the optical axis of themicroscope. U.S. Pat. No. 5,321,447 concerns a surgical microscope forperforming ophthalmic operations which can selectably be equipped withan ophthalmoscopy attachment that effects image erection of theintermediate image produced by an ophthalmoscope lens, transposes theobservation beam paths, and allows the surgical microscope to be usedselectably in conventional fashion or as an ophthalmoscope, with no needto make modifications to the surgical microscope.

[0008] Devices for the examination of eyes are, for example, tonometers,which once again exist in various embodiments. Current standardtonometers ascertain intraocular pressure by means of a narrow jet ofair that is blown onto the eye, its effects on the ocular surface beingascertained. As is known, for example, from U.S. Pat. No. 5,474,066, itis possible to use for this purpose an optical unit with which the eyeis illuminated and the light reflected from the eye is detected. Theintraocular pressure thus ascertained is indicated on a display.

[0009] Tonometers that operate with ultrasonic waves instead of air havealso already been proposed, for example in U.S. Pat. No. 5,636,635.

[0010] It is furthermore known to combine with one another diagnosticunits that ascertain or determine different measurement or examinationdata of the eye. A combination of a tonometer with a second diagnosticunit for examining the back of the eye is known, for example, from U.S.Pat. No. 5,523,808. The tonometer used here works with air that is blownonto the retina [sic] through a nozzle positioned in front of the eye.The nozzle blows air onto the eye in a position that lies slightlyoutside the optical axis of the second optical examination device.Because of the curvature of the cornea, the latter is acted upon withair substantially perpendicularly.

[0011] In certain ophthalmic operations, the danger exists thatinadvertent damage may occur, for example, to the retina. This can bethe case, for example, if the administration of certain medications canresult in an elevation of intraocular pressure, if an operation isperformed on the eye of a person who is already exhibiting elevatedintraocular pressure, or also directly in conjunction with theoperation. Intraocular pressure is therefore also measured before eachoperation.

SUMMARY OF THE INVENTION

[0012] In many operations or examinations, it is fundamentally desirableto have available certain parameters of the specimen in question thatcannot be ascertained by way of the particular surgical method orexamination method, so that the operation or examination can beperformed as optimally as possible, in particular without endangeringthe patient or the specimen being examined. A solution to this problemis therefore the fundamental object of the invention.

[0013] In particular, it is the object of the invention to be able toprevent, at least in most cases, the occurrence of damage to the eyeduring an operation as a consequence of intraocular pressure.

[0014] The basic object is achieved, according to the present invention,in that during the operation or examination, specimen data that areascertained or determined by the measurement device are directlydisplayable in the microscope as an optical signal; and/or that in theevent the measured data of the specimen exceed or fall below thresholdvalues and/or interval values, especially as a function of furtherparameters such as time or temperature, a warning signal is triggerableby way of which further actions, such as shutdown or switchover actions,can be automatically executed as applicable.

[0015] As far as the performance of ophthalmic operations is concerned,the stated object is achieved, according to the present invention, inthat in combination with the microscope a tonometer for measuring andascertaining intraocular pressure during the operation is provided; andthat either the surgical microscope comprises an apparatus forreflecting into the eyepiece system at least one optical signal that iscorrelated with the intraocular pressure, or the tonometer, uponoccurrence of a pathological intraocular pressure value, emits a signalthat is audible in the microscope area.

[0016] In novel fashion and according to the present invention,therefore, simultaneous measurement of the eye or specimen occurs duringobservation thereof through the magnification device.

[0017] One design of a surgical microscope configured according to thepresent invention comprises a device with which at least one opticalsignal that correlates with data concerning the intraocular pressure ofthe eye presently being operated on can be reflected into the eyepiecesystem.

[0018] The invention allows a modification of the manipulating techniqueof the microscopically observing entity or operating entity inaccordance with the situation. This can be, for example, automaticstoppage of the procedure in question, for example the surgicalintervention. In this context, let it be mentioned that the term“microscopically observing entity” or “operating entity” is to beunderstood not only as a person (a surgeon) but also as amicromanipulator or a robot, the latter also, as a rule, forwardingoptical data and signals via telecommunications to an observing orcontrolling person.

[0019] In the context of ophthalmic operations in particular, theinvention permits the operator to ascertain and observe the intraocularpressure and its changes during the operation and to react promptly whennecessary, whether by administering medications or by taking otherappropriate actions.

[0020] According to a preferred embodiment of the invention, the opticalsignal is reflected in from outside. This simplifies the construction ofthe entire device and the construction of the optical device required inthe surgical microscope for reflection.

[0021] In one of the variant embodiments of the invention, the opticalsignal can be the measured value ascertained by the tonometer anddisplayed on a display. The operator is thereby given the capability ofreading, in the microscope, the measured value that is actually beingascertained.

[0022] In a further variant embodiment of the invention, the opticalsignal is the light of a warning lamp. This very simple embodiment,requiring little complexity, is also favorable for the operator, sincehe or she needs to pay attention only to the light of a warning lamp.One economical and reliable embodiment provides for the light to be aspot of light, in particular an LED display.

[0023] In order to give the operator the opportunity to concentrateentirely on his or her activity, it is advantageous if the opticalsignal is reflected in only if a value exceeds or falls below apreviously established threshold.

[0024] Alternatively or additionally, according to a further variantembodiment of the invention provision can be made for the optical signalto change color conspicuously (e.g. green, yellow, red) in the event avalue exceeds or falls below a previously established threshold. Thisfeature as well makes it easy for the operator to observe the signal.

[0025] Another contribution to a simple and reliable configuration forthe entire device and the surgical microscope is made if the display andthe warning light are directly coupled to the tonometer in terms ofdata.

[0026] In order to direct the operator's attention to an even greaterdegree to a situation that may be dangerous, provision can further bemade for the optical signal to be combined with an acoustic signal; orfor the acoustic signal to occur instead of an optical signal.

BRIEF DESCRIPTION OF THE DRAWINGS

[0027] The invention will now be explained in more detail with referenceto the drawings, which depict an exemplary embodiment. The single Figureof the drawings,

[0028]FIG. 1, schematically depicts one possible combination accordingto the present invention of a surgical microscope with a tonometer.

DETAILED DESCRIPTION OF THE INVENTION

[0029] The embodiment of a surgical microscope 1 depicted in the Figurecomprises as the essential optical component a main objective 2 a, 2 bthrough which an eye 10 previously placed in front of it can beobserved, magnification changers 3 a, 3 b, tube lenses 4 a, 4 b, anderecting prisms 7 a, 7 b for the two separate beam paths. Arrangedbetween magnification changers 3 a, 3 b and tube lenses 4 a, 4 b in eachbeam path is a beam splitter 8 a , 8 b whose purpose will be discussedlater. Instead of both beam splitters 8 a, 8 b, it is also possible foronly one of these beam splitters to be provided. Stereoscopicobservation takes place through two binocular tubes 6 a, 6 b. Theconfiguration of surgical microscope 1 fundamentally corresponds, withthe exception of beam splitters 8 a, 8 b, to a usual configuration asknown from the existing art. Beam splitters for reflecting in data ofother kinds, for example for reflecting in CT or MRI data, are also partof the existing art.

[0030] In FIG. 1, surgical microscope 1 is positioned with Tespect toeye 10 being operated on so that its optical axis coincides with thevisual axis of eye 10. Also simultaneously positioned in front of eye 10is a tonometer 11, which in this exemplary embodiment is a tonometerfunctioning in noncontact fashion that thus ascertains the intraocularpressure without eye contact, in particular by way of compressed airpulses applied onto the eye. Tonometer 11 comprises a nozzle 12, to bepositioned in front of the eye, through which the cornea can be actedupon by compressed air. As already mentioned, tonometer 11 is not thesubject matter of the invention and can be configured, for example,according to U.S. Pat. No. 5,474,066 or 5,636,635, or can be one of theother units obtainable through appropriate commercial channels.Information relating thereto, in particular in the drawings anddescriptions of the drawings of the aforecited documents of the existingart, is also considered disclosed herein.

[0031] In the exemplary embodiment depicted, tonometer 11 comprises adevice 13 for generating compressed air; an optical unit 14 comprising alight source 14 that is provided for illuminating eye 10 and fordetecting light reflected from eye 10; and an electronic computer unit15 which on the one band controls and regulates all the functions oftonometer 11 and on the other hand receives and evaluates the measureddata that are determined, and thus ascertains and displays therespective intraocular pressure.

[0032] According to the invention, in ophthalmic operations that areperformed with surgical microscope 1 the intraocular pressure, and thusalso any changes therein, is ascertained via tonometer 11 continuouslyor at, in particular, regular time intervals. In order to ensure promptand constant observation of the measured data by the operator and toensure a quick reaction in the event a value exceeds or falls below aspecific threshold, an optical signal is reflected into the eyepiece ofsurgical microscope 1. For that purpose, the measured data ascertained,in the exemplary embodiment, via computer unit 15 are displayedoptically on a display 16 as a measured value which is transferred intothe interior of the microscope via an optical device in microscope 1that comprises e.g. a stop 17 and a lens 18, directed via beam splitter8 a into the beam path in the direction of binocular tubes 6 a, 6 b, andthus displayed inside microscope 1.

[0033] Provision can then be made for the measured data to be reflectedin either continuously or only if a value has already exceeded or fallenbelow a specific threshold that can be previously established. In thiscontext, provision can also be made for the color of the display tochange if certain values become too high or too low. It is suitable inthis context, for example, for measured data that are considered safe tobe reflected in in green, and for those data that require more detailedexamination or should trigger an immediate reaction to be reflected inin red.

[0034] Additionally or alternatively, according to a further exemplaryembodiment that is also shown in FIG. 1, provision is made for a warninglamp 19 to be activated via computer unit 15. Warning lamp 19, which canbe an LED display, lights up when specific measured data exceed or fallbelow a limit. The light of warning lamp 19 is reflected into theeyepiece of surgical microscope 1 by means of a lens 20 and via beamsplitter 8 b. A safe measured value can appear, for example, as a green,in particular spot-shaped, light in the eyepiece; if specific measuredvalues exceed or fall below a threshold, that spot of light can changecolor, in particular to red. The optical signal display can moreoveralso be supplemented with or replaced by an acoustic signal.

[0035] The intraocular pressure normally fluctuates only slightly around17 mnmHg. The fact that the value exceeds, for example, 20 mmHg, perhapsalso for a longer period of time, may therefore be considered asituation in which a corresponding warning is given to the operator viaone of the means described. A decrease in intraocular pressure can alsobe indicated in this fashion.

[0036] The invention can be used for routine monitoring in certainophthalmic operations in which the possibility exists of an excessiverise in intraocular pressure, for example because of the administrationof medications. The invention is of particular advantage in the contextof ophthalmic operations on persons who belong to the risk group ofthose in whom an elevated intraocular pressure has already beenidentified.

[0037] The invention is not limited to the exemplary embodiment depictedand described. In addition to the further possibilities alreadymentioned in the specification, reference is made in particular to thefact that the surgical microscope can be configured differently from theembodiment depicted. In principle, for most known and obtainablesurgical microscopes, the tonometer measured values can be reflected inby way of simple adaptations in design.

[0038] In the case of loupes or the like, reflecting in can be omittedin some circumstances by the fact that the warning signal is mounteddirectly on the loupe in the visible area. In special cases, forexample, it can be configured as a miniature bulb or LED or the likedirectly on the rim of the loupe.

[0039] The tonometer can moreover function with ultrasonic waves or bycontact measurement, instead of with compressed air.

[0040] A surgical microscope according to the present invention canfurthermore be equipped with an ophthalmoscopy attachment formicroscopic observation of the fundus or of areas of the vitreous bodyof the eye near the fundus.

[0041] The embodiment of a surgical microscope 1 depicted in the Figurecomprises as the essential optical component a main objective 2 a, 2 bthrough which an eye 10 previously placed in front of it can beobserved, magnification changers 3 a, 3 b, tube lenses 4 a, 4 b, anderecting prisms 7 a, 7 b for the two separate beam paths. Arrangedbetween magnification changers 3 a, 3 b and tube lenses 4 a, 4 b in eachbeam path is a beam splitter 8 a, 8 b whose purpose will be discussedlater. Instead of both beam splitters 8 a, 8 b, it is also possible foronly one of these beam splitters to be provided. Stereoscopicobservation takes place through two binocular tubes 6 a , 6 b. Theconfiguration of surgical microscope 1 fundamentally corresponds, withthe exception of beam splitters 8 a, 8 b, to a usual configuration asknown from the existing art. Beam splitters for reflecting in data ofother kinds, for example for reflecting in CT or MRI data, are also partof the existing art.

[0042] In FIG. 1, surgical microscope 1 is positioned with respect toeye 10 being operated on so that its optical axis coincides with thevisual axis of eye 10. Also simultaneously positioned in front of eye 10is a tonometer 11, which in this exemplary embodiment is a tonometerfimctioning in noncontact fashion that thus ascertains the intraocularpressure without eye contact, in particular by way of compressed airpulses applied onto the eye. Tonometer 11 comprises a nozzle 12, to bepositioned in front of the eye, through which the cornea can be actedupon by compressed air. As already mentioned, tonometer 11 is not thesubject matter of the invention and can be configured, for example,according to U.S. Pat. No. 5,474,066 or 5,636,635, or can be one of theother units obtainable through appropriate conunercial channels.Information relating thereto, in particular in the drawings anddescriptions of the drawings of the aforecited documents of the existingart, is also considered disclosed herein.

[0043] In the exemplary embodiment depicted, tonometer 11 comprises adevice 13 for generating compressed air; an optical unit 14 comprising alight source 14 that is provided for illuminating eye 10 and fordetecting light reflected from eye 10; and an electronic computer unit15 which on the one hand controls and regulates all the functions oftonometer 11 and on the other hand receives and evaluates the measureddata that are determined, and thus ascertains and displays therespective intraocular pressure.

[0044] According to the invention, in ophthalmic operations that areperformed with surgical microscope I the intraocular pressure, and thusalso any changes therein, is ascertained via tonometer 11 continuouslyor at, in particular, regular time intervals. In order to ensure promptand constant observation of the measured data by the operator and toensure a quick reaction in the event a value exceeds or falls below aspecific threshold, an optical signal is reflected into the eyepiece ofsurgical microscope 1. For that purpose, the measured data ascertained,in the exemplary embodiment, via computer unit 15 are displayedoptically on a display 16 as a measured value which is transferred intothe interior of the microscope via an optical device in microscope 1that comprises e.g. a stop 17 and a lens 18, directed via beam splitter8 a into the beam path in the direction of binocular tubes 6 a, 6 b, andthus displayed inside microscope 1.

[0045] Provision can then be made for the measured data to be reflectedin either continuously or only if a value has already exceeded or fallenbelow a specific threshold that can be previously established. In thiscontext, provision can also be made for the color of the display tochange if certain values become too high or too low. It is suitable inthis context, for example, for measured data that are considered safe tobe reflected in in green, and for those data that require more detailedexamination or should trigger an immediate reaction to be reflected inin red.

[0046] Additionally or alternatively, according to a further exemplaryembodiment that is also shown in FIG. 1, provision is made for a warninglamp 19 to be activated via computer unit 15. Warning lamp 19, which canbe an LED display, lights up when specific measured data exceed or fallbelow a limit. The light of warning lamp 19 is reflected into theeyepiece of surgical microscope 1 by means of a lens 20 and via beamsplitter 8 b. A safe measured value can appear, for example, as a green,in particular spot-shaped, light in the eyepiece; if specific measuredvalues exceed or fall below a threshold, that spot of light can changecolor, in particular to red. The optical signal display can moreoveralso be supplemented with or replaced by an acoustic signal.

[0047] The intraocular pressure normally fluctuates only slightly around17 nmHg. The fact that the value exceeds, for example, 20 mmHg, perhapsalso for a longer period of time, may therefore be considered asituation in which a corresponding warning is given to the operator viaone of the means described. A decrease in intraocular pressure can alsobe indicated in this fashion.

[0048] The invention can be used for routine monitoring in certainophthalmic operations in which the possibility exists of an excessiverise in intraocular pressure, for example because of the administrationof medications. The invention is of particular advantage in the contextof ophthalmic operations on persons who belong to the risk group ofthose in whom an elevated intraocular pressure has already beenidentified.

[0049] The invention is not limited to the exemplary embodiment depictedand described. In addition to the further possibilities alreadymentioned in the specification, reference is made in particular to thefact that the surgical microscope can be configured differently from theembodiment depicted. In principle, for most known and obtainablesurgical microscopes, the tonometer measured values can be reflected inby way of simple adaptations in design.

[0050] In the case of loupes or the like, reflecting in can be omittedin some circumstances by the fact that the warning signal is mounteddirectly on the loupe in the visible area. In special cases, forexample, it can be configured as a miniature bulb or LED or the likedirectly on the rim of the loupe.

[0051] The tonometer can moreover function with ultrasonic waves or bycontact measurement, instead of with compressed air.

[0052] A surgical microscope according to the present invention canfurthermore be equipped with an ophthalmoscopy attachment formicroscopic observation of the fundus or of areas of the vitreous bodyof the eye near the fundus.

Parta List

[0053]1 Surgical microscope

[0054]2 a, 2 b Main objective

[0055]3 a, 3 b Magnification changers

[0056]4 a, 4 b Tube lenses

[0057]7 a, 7 b Erecting prisms

[0058]6 a, 6 b Binocular tubes

[0059]8 a, 8 b Beam splitters

[0060]10 Eye

[0061]11 Tonometer

[0062]12 Nozzle

[0063]13 Device for generating compressed air pulses

[0064]14 Optical unit

[0065]15 Computer unit

[0066]16 Display

[0067]17 Stop

[0068]18 Lens

[0069]19 Warning lamp

[0070]20 Lens

What is claimed is:
 1. A combination of a magnification device, in particular a microscope, with a measurement device, in particular a diagnostic device, usable during an operation on or examination of a specimen performed with the microscope, wherein during the operation or examination, specimen data that are ascertained or determined by the measurement device are directly displayable in the microscope as an optical signal; and/or in the event the measured data of the specimen exceed or fall below threshold values and/or interval values, especially as a function of further parameters such as time or temperature, a warning signal is triggerable by way of which further actions, such as shutdown or switchover actions, can be automatically executed as applicable.
 2. A device for use during the performance of operations on a human or animal body part, in particular on the human or animal eye, with a magnification device, in particular with a surgical microscope which comprises an objective system and optical devices for viewing the eye through an eyepiece system, wherein in combination with the microscope a tonometer for measuring and ascertaining intraocular pressure during the operation is provided; and either the surgical microscope comprises an apparatus for reflecting in—preferably into the eyepiece system—at least one optical signal that is correlated with the intraocular pressure, or the tonometer, upon occurrence of a pathological intraocular pressure value, emits a signal that is audible in the microscope area.
 3. A magnification device, in particular a microscope, especially a surgical microscope, for performing operations on the human or animal eye, having an objective system and optical devices for viewing the eye, wherein the magnification device or microscope comprises a further optical device with which at least one optical signal that correlates with data concerning the intraocular pressure of the eye presently being operated on can be reflected into the observation beam path.
 4. The device or surgical microscope as defined in claim 2 or 3, wherein the optical signal can be reflected in from outside.
 5. The device or surgical microscope as defined in one of claims 2 through 4, wherein the optical signal is the measured value ascertained by the tonometer and displayed on a display.
 6. The device or surgical microscope as defined in one of claims 2 through 4, wherein the optical signal is the light of a warning lamp.
 7. The device or surgical microscope as defined in claim 6, wherein the light is a spot of light, in particular an LED display.
 8. The device or surgical microscope as defined in one of claims 1 through 7, wherein the optical signal is reflected in if a value exceeds or falls below a previously established threshold.
 9. The device or surgical microscope as defined in one of claims 1 through 7, wherein the optical signal conspicuously changes its color in the event a value exceeds or falls below a previously established threshold.
 10. The device or surgical microscope as defined in one of claims 1 through 9, wherein the display and the warning light are coupled to the tonometer in terms of data.
 11. The device or surgical microscope as defined in one of claims 1 through 10, wherein the optical signal is combined with an acoustic signal. 